Protein gene product 9.5-immunoreactive nerves and cells in human oral mucosa.

Current conflicting information on the innervation of the human oral cavity indicates technical problems such as different detectability of the neural structures according to the various staining methods used and difficulties in reproducibility. The possibility of intraoral regional differences has not been properly considered. Human biopsies of mucosa from different intraoral regions were prepared for immunohistochemistry using protein gene product 9.5 (PGP 9.5; a marker for neuronal structures). Nerves were found consistently in all the biopsies. The neural pattern showed clear regional differences. Intraepithelial nerve fibers were found in the gingiva, labia, palate, within certain fungiform papillae, and in some salivary excretory ducts. Organized nerve endings were found in varying frequencies in all but one (sublingual) region, appearing as lamellar (Meissner-like), coiled or glomerular neural structures. Merkel cell-neurite complexes were observed in the buccal, gingival, and palatal epithelia. Immunoreactive cells with many similarities to Merkel cells but without a neural connection were also encountered. Conflicting results from earlier innervation studies of the oral cavity could be attributed to regional innervation differences. The distribution of the nerves also casts doubt on some of the present theories concerning the function(s) of intraoral nerves, such as the free nerve endings and the Merkel cell-neurite complexes.